Activate your Active Care

For ages 12 to 18 years old

Before you proceed to activate, please take note of the following:

Do have your ActiveSG Receipt number on hand.
For multiple purchases of Active Care, please submit one (1) form per child. You may use the same ActiveSG receipt number.
Active Care coverage will only commence upon successful submission of this activation form. You will receive an email confirmation upon successful activation.

Thank you for purchasing Active Care for your child.

Complete the form below to activate Active Care

Statement pursuant to Section 25(5) of the Insurance Act (Cap 142) (or any subsequent amendments thereof), you are to disclose in this proposal form, fully and faithfully, all the facts you know, or ought to know, which may affect the insurance cover you are applying for. Otherwise, you may receive nothing from the policy.

ActiveSG Receipt No.

Insured Name

Insured's NRIC / Birth Certificate No.

Insured's Date of Birth

Mobile No.

Parent's Name

Parent's NRIC

PDPA Consent Clause

By providing the information set out above, I/we agree and consent to Great Eastern and its related corporations (collectively, the "Companies"), as well as their respective representatives, agents, the Companies' authorised service providers and relevant third parties (the Companies and all the other foregoing parties, collectively, “Great Eastern Persons”), collecting, using, disclosing, and/or sharing amongst themselves my/our personal data, for purposes reasonably required by the Companies to evaluate my/our proposal and to provide the products or services which I am/ we are applying for (including any policy renewals and policy upgrades, substitutions or replacements) and such other purposes as described in Great Eastern's Privacy Statement (collectively, the “Purposes”) which is accessible from Great Eastern Singapore’s website at https://www.greateasternlife.com, which I/we confirm I/we have read and understood. My/our consents herein supplement but do not supersede nor replace any other consents I/we may have previously provided to Great Eastern Persons, and my/our consents herein are cumulative and additional to any rights which any of the Great Eastern Persons may have to collect, use, and/or disclose of my/our Personal Data, with or without my/our consent, to the extent permitted under applicable law. In addition, where personal data of any person is disclosed by me/us, I/we further confirm and represent that I/we have obtained the consent of the individual concerned for the Purposes, unless such consent is not required under applicable laws: (i) to collect such personal data; (ii) for the disclosure of such personal data to the Great Eastern Persons; and (iii) for the Great Eastern Persons’ collection, use and/or disclosure of such personal data.

Declaration

By activating Active Care, I agree to the Terms & Conditions and Important Notes.

Learn more about Active Care:

» Policy Wordings

» Terms and Conditions and Important Notes

» FAQ

Life and health

Wealth

Lifestyle

Government schemes

Prestige series

Activate your Active Care

For ages 12 to 18 years old

Before you proceed to activate, please take note of the following:

Complete the form below to activate Active Care

Learn more about Active Care:

Your search history

Life and health

Wealth

Lifestyle

Government schemes

Prestige series

Activate your Active Care

For ages 12 to 18 years old

Before you proceed to activate, please take note of the following:

Complete the form below to activate Active Care

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Learn more about Active Care: